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NPI Code Detail

MEDICARE: ALLYSON SAMBACH DNP, PMHNP-BC

MEDICARE: ALLYSON SAMBACH DNP, PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner240171AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2240171OTHERAZLICENSE NUMBER

General Provider Information

NPI Number : 1750910337
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLYSON SAMBACH DNP, PMHNP-BC
Provider Business Mailing Address
First Line : 7500 N DREAMY DRAW DR STE 145
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-4668
Country : US
Telephone Number : 480-882-4545
Fax Number : 602-409-0499
Provider Business Practice Location Address
First Line : 11851 N 51ST AVE STE F140
Second Line :
City : GLENDALE
State : AZ
Zip : 85304-2847
Country : US
Telephone Number : 480-882-4545
Fax Number : 623-242-1314
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2020
Last Update Date : 10/03/2023

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